Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-13T03:03:22.684Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of maternal zinc supplementation on the cardiometabolic profile of Peruvian children: results from a randomized clinical trial

Published online by Cambridge University Press:  17 October 2016

M. L. Mispireta ,
L. E. Caulfield ,
N. Zavaleta ,
M. Merialdi ,
D. L. Putnick ,
M. H. Bornstein  and
J. A. DiPietro
M. L. Mispireta
Affiliation:
Kasiska School of Health Professions, Idaho State University, Pocatello, ID, USA Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
L. E. Caulfield*
Affiliation:
Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
N. Zavaleta
Affiliation:
Instituto de Investigación Nutricional, Lima, Peru
M. Merialdi
Affiliation:
Global Health Division, Becton Dickinson, Franklin Lakes, NJ, USA
D. L. Putnick
Affiliation:
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
M. H. Bornstein
Affiliation:
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
J. A. DiPietro
Affiliation:
Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
*
*Address for correspondence: L. E. Caulfield, Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W2041, Baltimore, MD 21205, USA. (Email lcaulfi1@jhu.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Zinc is an essential micronutrient for the development of the fetal renal, cardiovascular and metabolic systems; however, there is limited evidence of its effects on the postnatal cardiometabolic function. In this study, we evaluated the effect of maternal zinc supplementation during pregnancy on the cardiometabolic profile of the offspring in childhood. A total of 242 pregnant women were randomly assigned to receive a daily supplement containing iron+folic acid with or without zinc. A follow-up study was conducted when children of participating mothers were 4.5 years of age to evaluate their cardiometabolic profile, including anthropometric measures of body size and composition, blood pressure, lipid profile and insulin resistance. No difference in measures of child cardiometabolic risk depending on whether mothers received supplemental zinc during pregnancy. Our results do not support the hypothesis that maternal zinc supplementation reduces the risk of offspring cardiometabolic disease.

Keywords

cardiovascularmetaboliczinc
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 8 , Issue 1 , February 2017 , pp. 56 - 64
Check for updates
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2016. This is a work of the U.S. Government and is not subject to copyright protection in the United States. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. World Health Organization. (ed.) Global Status Report on Noncommunicable Diseases. 2014. WHO: Geneva.Google Scholar
2. Barker, DJ, Gluckman, PD, Godfrey, KM, et al. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993; 341, 938–941.Google Scholar
3. Barker, DJ. The developmental origins of insulin resistance. Horm Res. 2005; 64(Suppl. 3), 2–7.Google Scholar
4. Christian, P, Stewart, CP. Maternal micronutrient deficiency, fetal development, and the risk of chronic disease. J Nutr. 2010; 140, 437–445.Google Scholar
5. Tomat, A, Inserra, F, Veiras, L, et al. Moderate zinc restriction during fetal and postnatal growth of rats: effects on adult arterial blood pressure and kidney. Am J Physiol Regul Comp Physiol. 2008; 295, R543–R549.Google Scholar
6. Padmavathi, IJ, Kishore, YD, Venu, L, et al. Prenatal and perinatal zinc restriction: effects on body composition, glucose tolerance and insulin response in rat offspring. Exp Physiol. 2009; 94, 761–769.Google Scholar
7. Stewart, CP, Christian, P, Schulze, KJ, et al. Antenatal micronutrient supplementation reduces metabolic syndrome in 6- to 8-year-old children in rural Nepal. J Nutr. 2009; 139, 1575–1581.CrossRefGoogle ScholarPubMed
8. Stewart, CP, Christian, P, LeClerq, SC, West, KP, Khatry, SK. Antenatal supplementation with folic acid+iron+zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal. Am J Clin Nutr. 2009; 90, 132–140.CrossRefGoogle ScholarPubMed
9. Caulfield, LE, Zavaleta, N, Shankar, AH, Merialdi, M. Potential contribution of maternal zinc supplementation during pregnancy to maternal and child survival. Am J Clin Nutr. 1998; 68(Suppl. 2), 499S–508S.Google Scholar
10. Lee, SE, Talegawkar, SA, Merialdi, M, Caulfield, LE. Dietary intakes of women during pregnancy in low- and middle-income countries. Public Health Nutr. 2013; 16, 1340–1353.CrossRefGoogle ScholarPubMed
11. Sacco, LM, Caulfield, LE, Zavaleta, N, Retamozo, L. Dietary pattern and usual nutrient intakes of Peruvian women during pregnancy. Eur J Clin Nutr. 2003; 57, 1492–1497.Google Scholar
12. Caulfield, LE, Zavaleta, N, Figueroa, A. Adding zinc to prenatal iron and folate supplements improves maternal and neonatal zinc status in a Peruvian population. Am J Clin Nutr. 1999; 69, 1257–1263.Google Scholar
13. Caulfield, LE, Donangelo, CM, Chen, P, et al. Red blood cell metallothionein as an indicator of zinc status during pregnancy. Nutrition. 2008; 24, 1081–1087.Google Scholar
14. Merialdi, M, Caulfield, LE, Zavaleta, N, et al. Randomized controlled trial of prenatal zinc supplementation and fetal bone growth. Am J Clin Nutr. 2004; 79, 826–830.CrossRefGoogle ScholarPubMed
15. Merialdi, M, Caulfield, LE, Zavaleta, N, et al. Randomized controlled trial of prenatal zinc supplementation and the development of fetal heart rate. Am J Obstet Gynecol. 2004; 190, 1106–1112.CrossRefGoogle ScholarPubMed
16. Caulfield, LE, Zavaleta, N, Chen, P, et al. Maternal zinc supplementation during pregnancy affects autonomic function of Peruvian children assessed at 54 months of age. J Nutr. 2011; 141, 327–332.Google Scholar
17. Camhi, SM, Katzmarzyk, PT. Tracking of cardiometabolic risk factor clustering from childhood to adulthood. Int J Pediatr Obes. 2010; 5, 122–129.CrossRefGoogle ScholarPubMed
18. Caulfield, LE, Putnick, DL, Zavaleta, N, et al. Maternal gestational zinc supplementation does not influence multiple aspects of child development at 54 mo of age in Peru. Am J Clin Nutr. 2010; 92, 130–136.Google Scholar
19. Lohman, T, Roche, A, Martorell, R. Anthropometric Standardization Reference Manual. 1988; p. 18. Human Kinetics Pub: Champaign, IL.Google Scholar
20. World Health Organization. WHO Child Growth Standards: Methods and Development: Length/Height-For-Age, Weight-For-Age, Weight-For-Length, Weight-For-Height and Body Mass Index-For-Age. 2006. WHO: Geneva.Google Scholar
21. Boutton, TW, Trowbridge, FL, Nelson, MM, et al. Body composition of Peruvian children with short stature and high weight-for-height. I. Total body-water measurements and their prediction from anthropometric values. Am J Clin Nutr. 1987; 45, 513–525.Google Scholar
22. Expert Panel on Blood Cholesterol Levels in Children and Adolescents. National Cholesterol Education Program (NCEP) highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992; 89, 495–501.Google Scholar
23. Friedewald, WT, Levy, RI, Fredrickson, DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18, 499–502.Google Scholar
24. Matthews, DR, Hosker, JP, Rudenski, AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28, 412–419.CrossRefGoogle ScholarPubMed
25. Tobin, J. Estimation of relationships for limited dependent variables. Econometrica. 1958; 26, 24–36.Google Scholar
26. Tukey, J. Exploratory Data Analysis. 1977. Addison-Wesley: Reading, MA.Google Scholar
27. Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285, 2486–2497.Google Scholar
28. Fernández, JR, Redden, DT, Pietrobelli, A, Allison, DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004; 145, 439–444.Google Scholar
29. Daniels, SR, Greer, FR, Nutrition Co. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008; 122, 198–208.Google Scholar
30. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004; 114(Suppl. 2 4th Report), 555–576.Google Scholar
31. American Diabetes Association. Standards of medical care in diabetes – 2014. Diabetes Care. 2014; 37(Suppl. 1), S14–S80.Google Scholar
32. Ferguson, C. An effect size primer: a guide for clinicians and researchers. Prof Psychol Res Pr. 2009; 40, 532–538.Google Scholar
33. Hawkesworth, S, Wagatsuma, Y, Kahn, AI, et al. Combined food and micronutrient supplements during pregnancy have limited impact on child blood pressure and kidney function in rural Bangladesh. J Nutr. 2013; 143, 728–734.Google Scholar
34. Vaidya, A, Saville, N, Shrestha, BP, et al. Effects of antenatal multiple micronutrient supplementation on children’s weight and size at 2 years of age in Nepal: follow-up of a double-blind randomised controlled trial. Lancet. 2008; 371, 492–499.Google Scholar
35. Singh, RB, Niaz, MA, Rastogi, SS, et al. Current zinc intake and risk of diabetes and coronary artery disease and factors associated with insulin resistance in rural and urban populations of North India. J Am Coll Nutr. 1998; 17, 564–570.Google Scholar
36. Li, Y, Guo, H, Wu, M, Liu, M. Serum and dietary antioxidant status is associated with lower prevalence of the metabolic syndrome in a study in Shanghai, China. Asia Pac J Clin Nutr. 2013; 22, 60–68.Google Scholar
37. Sun, Q, van Dam, RM, Willett, WC, Hu, FB. Prospective study of zinc intake and risk of type 2 diabetes in women. Diabetes Care. 2009; 32, 629–634.Google Scholar
38. Vashum, KP, McEvoy, M, Shi, Z, et al. Is dietary zinc protective for type 2 diabetes? Results from the Australian longitudinal study on women’s health. BMC Endocr Disord. 2013; 13–40.Google Scholar
39. Capdor, J, Foster, M, Petocz, P, Samman, S. Zinc and glycemic control: a meta-analysis of randomised placebo controlled supplementation trials in humans. J Trace Elem Med Biol. 2013; 27, 137–142.Google Scholar
40. Jayawardena, R, Ranasinghe, P, Galappatthy, P, et al. Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr. 2012; 4, 13.Google Scholar
41. Foster, M, Petocz, P, Samman, S. Effects of zinc on plasma lipoprotein cholesterol concentrations in humans: a meta-analysis of randomised controlled trials. Atherosclerosis. 2010; 210, 344–352.Google Scholar
42. Kuchmak, M, Taylor, L, Olansky, AS. Suitability of frozen and lyophilized reference sera for cholesterol and triglyceride determinations. Clin Chim Acta. 1982; 120, 261–271.Google Scholar
43. Tiedink, HG, Katan, MB. Variability in lipoprotein concentrations in serum after prolonged storage at −20 degrees C. Clin Chim Acta. 1989; 180, 147–155.Google Scholar
44. Meigs, JB, Haffner, SM, Nathan, DM, D’Agostino, RB, Wilson, PW. Sample exchange to compare insulin measurements between the San Antonio Heart Study and the Framingham Offspring Study. J Clin Epidemiol. 2001; 54, 1031–1036.Google Scholar
45. Haney, EM, Huffman, LH, Bougatsos, C, et al. Screening for Lipid Disorders in Children and Adolescents. 2007. Agency for Healthcare Research and Quality (US): Rockville, MD.Google Scholar
46. Litwin, M, Niemirska, A. Intima-media thickness measurements in children with cardiovascular risk factors. Pediatr Nephrol. 2009; 24, 707–719.Google Scholar
47. Buse, JB, Kaufman, FR, Linder, B, et al. Diabetes screening with hemoglobin A(1c) versus fasting plasma glucose in a multiethnic middle-school cohort. Diabetes Care. 2013; 36, 429–435.Google Scholar
48. Evelein, AM, Visseren, FL, van der Ent, CK, Grobbee, DE, Uiterwaal, CS. Excess early postnatal weight gain leads to increased abdominal fat in young children. Int J Pediatr. 2012; 2012, 1410656.Google Scholar
49. Evelein, AM, Visseren, FL, van der Ent, CK, Grobbee, DE, Uiterwaal, CS. Excess early postnatal weight gain leads to thicker and stiffer arteries in young children. J Clin Endocrinol Metab. 2013; 98, 794–801.Google Scholar
50. Ong, KK, Petry, CJ, Emmett, PM, et al. Insulin sensitivity and secretion in normal children related to size at birth, postnatal growth, and plasma insulin-like growth factor-I levels. Diabetologia. 2004; 47, 1064–1070.Google Scholar
51. Iannotti, LL, Zavaleta, N, León, Z, Caulfield, LE. Growth and body composition of Peruvian infants in a periurban setting. Food Nutr Bull. 2009; 30, 245–253.Google Scholar
52. Chen, W, Bao, W, Begum, S, et al. Age-related patterns of the clustering of cardiovascular risk variables of syndrome X from childhood to young adulthood in a population made up of black and white subjects: the Bogalusa Heart Study. Diabetes. 2000; 49, 1042–1048.Google Scholar
53. Liese, AD, Mayer-Davis, EJ, Haffner, SM. Development of the multiple metabolic syndrome: an epidemiologic perspective. Epidemiol Rev. 1998; 20, 157–172.Google Scholar
54. Corvalán, C, Uauy, R, Kain, J, Martorell, R. Obesity indicators and cardiometabolic status in 4-y-old children. Am J Clin Nutr. 2010; 91, 166–174.Google Scholar
55. Cowin, I, Emmett, P. Cholesterol and triglyceride concentrations, birthweight and central obesity in pre-school children. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Int J Obes Relat Metab Disord. 2000; 24, 330–339.Google Scholar
56. Williams, CL, Strobino, B, Bollella, M, Brotanek, J. Body size and cardiovascular risk factors in a preschool population. Prev Cardiol. 2004; 7, 116–121.Google Scholar